Tumid Lupus Erythematosus: A Rare and Distinctive Variant of Cutaneous Lupus Erythematosus Masquerading as Urticarial Vasculitis

Abstract

Tumid lupus erythematosus (TLE) is a rare form of chronic cutaneous lupus that has triggered much debate regarding its clinical and histopathological features. It has been classically defined as annular erythematous, succulent, plaques involving the face and trunk that typically are devoid of any papulosquamous features such as scale and follicular plugging. These lesions are a clinical mimicker of other urticarial lesions such as urticarial vasculitis and lymphocytic infiltrate of Jessner. We report a case of TLE presenting in a 49-yearold Caucasian female whose initial clinical presentation was concerning for urticarial vasculitis due to presence of urticarial-like lesions present for approximately three months. Laboratory studies and histopathological correlations confirmed the diagnosis of TLE and the patient was successfully treated with topical corticosteroids.

Sjogren’s Syndrome Presenting with Solely Cutaneous Features

“…Upon literature review, there have been very few documented presentations of solely the cutaneous manifestations of Sjogren’s syndrome, and none in this specific manner of mimicking RP. The cutaneous findings associated with SS seem to be underestimated in general [ 8 ]. It is very important to maintain SS within the rheumatologic differential when approaching patients with new skin lesions, even without the classic keratoconjunctivitis sicca or xerostomia.…”

“…Even more exceptionally rare is tumid lupus erythematosus (TLE). It is considered a variant of chronic cutaneous lupus erythematosus and is difficult to diagnose [ 8 ]. Symptoms are limited to the skin and there are typically no other obvious presenting signs.…”

Tumid Lupus Erythematosus (TLE): A Review of a Rare Variant of Chronic Cutaneous Lupus Erythematosus (cCLE) with Emphasis on Differential Diagnosis

“…Etiopathogenesis of TLE has not been yet fully elucidated but is believed to involve a complex interplay between genetic, environmental, and immunological factors [19,21,22]. Ultraviolet (UV) radiation is a major triggering factor in most, but not all TLE patients [15,23].…”

Tumid Lupus Erythematosus Presenting as Patchy Alopecia: A Discussion of Alopecia Associated With Lupus Erythematosus

“…Tumid lupus erythematosus (TLE), a subtype of chronic cutaneous lupus erythematosus, presents with firm erythematous and edematous plaques that lack surface changes such as follicular plugging or scale [ 1 ]. These lesions most commonly occur on the face and other photosensitive areas, including the upper chest, upper back, extensor arms, and shoulders.…”